UF at forefront of using gene testing to tailor drugs

Published: Thursday, July 4, 2013 at 7:40 p.m.

Last Modified: Thursday, July 4, 2013 at 7:40 p.m.

While genetic testing to see if you have genes that make you prone to certain diseases is notably on the rise, another type of genetic testing — to determine which drugs will successfully treat you — is gaining momentum.

University of Florida researchers are at the forefront of that development, and a recently announced $3.7 million grant from the National Institutes of Health should help UF stay on course of being leaders in the field of pharmacogenetics.

The grant was awarded to three institutes around the country and coincides with the one-year anniversary of the UF Health Personalized Medicine Program, where the grant money will be used.

“We are at the front end of this. Less than a half dozen do it on this level,” said Julie Johnson, the program’s director and a professor of pharmacy and medicine at UF.

And patients already have reaped the rewards of genetic testing. In the past year, 27 percent of the more than 1,000 cardiology patients who were tested had a genetic variation that disqualified them from taking clopidogrel, the most commonly used anti-clotting medication given to patients who had stents placed to open up blocked arteries.

Based on this genetic information, clinicians were able to prescribe a different medication to the patients with the genetic variation.

“It saves time, money, and most importantly it will decrease stent thrombosis,” said Dr. David Nelson, the director of the UF Clinical Translational Science Institute, the umbrella institute for the UF Health Personalized Medicine Program. “There will be less heart attacks, heart failure, lower morbidity, and it will save lives.”

“For other scenarios, it’s about dosing,” Johnson said, adding that the testing could cut dosing by 90 percent for certain cancer drugs if 10 percent of the standard dose is actually what the patient can metabolize. “That helps to avoid a lot of toxicities,” she added.

Unlike genetic testing for certain diseases — such as the BRCA1 and 2 genes that are linked to breast cancer — testing for drug compatibility determines if the body has enzymes that will metabolize various classes of drugs, Johnson explained.

“Some of these enzymes metabolize hundreds of different drugs,” Johnson said, adding that 10 genes might cover 15-20 classes of drugs. Currently, 100 drugs on the marketplace — many of them widely used — have genetic information on their label, she added.

The test itself is a blood draw, and the results are back within 24 hours, Johnson said. “For the patient, from a testing perspective it’s super easy.”

The information then becomes a permanent part of a patient’s medical record.

“Your genetic info never changes,” Johnson said. “In the future if (patients) end up on a medication where that information is important, then that information is already there.”

The issue of when to get tested is still up for debate, Johnson continued. While some experts advocate for testing in infants — given that people are invariably going to need medication at some point in their lives — others suggest waiting until they actually need the medications.

Johnson and Nelson both agreed, however, that pre-emptive genetic testing in the population at large is where the future of pharmacogenetic testing is headed, especially in people at risk for certain diseases.

Part of the grant money will be used to develop educational materials for patients to share their genetic makeup with physicians.

While electronic health records facilitate the storage of the information and allow it to be shared within the same health care system, many patients are seen at multiple places, Johnson pointed out. This makes sharing their genetic information somewhat challenging.

“How do we educate patients? They may be the best people to share it with doctors in other systems. Do we create a little wallet card that they carry?” she asked.

Some of the grant money also will be used to expand services and physician training to First Orlando Health and Florida State University, and from there to community hospitals across the state, Johnson said.

“One of the things we will be doing with the grant is showing the state of Florida that we can make a large impact. In the end, it should be most beneficial to patients,” Nelson said, adding that genetic testing will also “improve efficiency and cost effectiveness.”

<p>While genetic testing to see if you have genes that make you prone to certain diseases is notably on the rise, another type of genetic testing — to determine which drugs will successfully treat you — is gaining momentum.</p><p>University of Florida researchers are at the forefront of that development, and a recently announced $3.7 million grant from the National Institutes of Health should help UF stay on course of being leaders in the field of pharmacogenetics.</p><p>The grant was awarded to three institutes around the country and coincides with the one-year anniversary of the UF Health Personalized Medicine Program, where the grant money will be used.</p><p>“We are at the front end of this. Less than a half dozen do it on this level,” said Julie Johnson, the program's director and a professor of pharmacy and medicine at UF.</p><p>And patients already have reaped the rewards of genetic testing. In the past year, 27 percent of the more than 1,000 cardiology patients who were tested had a genetic variation that disqualified them from taking clopidogrel, the most commonly used anti-clotting medication given to patients who had stents placed to open up blocked arteries.</p><p>Based on this genetic information, clinicians were able to prescribe a different medication to the patients with the genetic variation.</p><p>“It saves time, money, and most importantly it will decrease stent thrombosis,” said Dr. David Nelson, the director of the UF Clinical Translational Science Institute, the umbrella institute for the UF Health Personalized Medicine Program. “There will be less heart attacks, heart failure, lower morbidity, and it will save lives.”</p><p>“For other scenarios, it's about dosing,” Johnson said, adding that the testing could cut dosing by 90 percent for certain cancer drugs if 10 percent of the standard dose is actually what the patient can metabolize. “That helps to avoid a lot of toxicities,” she added.</p><p>Unlike genetic testing for certain diseases — such as the BRCA1 and 2 genes that are linked to breast cancer — testing for drug compatibility determines if the body has enzymes that will metabolize various classes of drugs, Johnson explained.</p><p>“Some of these enzymes metabolize hundreds of different drugs,” Johnson said, adding that 10 genes might cover 15-20 classes of drugs. Currently, 100 drugs on the marketplace — many of them widely used — have genetic information on their label, she added.</p><p>The test itself is a blood draw, and the results are back within 24 hours, Johnson said. “For the patient, from a testing perspective it's super easy.”</p><p>The information then becomes a permanent part of a patient's medical record.</p><p>“Your genetic info never changes,” Johnson said. “In the future if (patients) end up on a medication where that information is important, then that information is already there.”</p><p>The issue of when to get tested is still up for debate, Johnson continued. While some experts advocate for testing in infants — given that people are invariably going to need medication at some point in their lives — others suggest waiting until they actually need the medications.</p><p>Johnson and Nelson both agreed, however, that pre-emptive genetic testing in the population at large is where the future of pharmacogenetic testing is headed, especially in people at risk for certain diseases.</p><p>Part of the grant money will be used to develop educational materials for patients to share their genetic makeup with physicians.</p><p>While electronic health records facilitate the storage of the information and allow it to be shared within the same health care system, many patients are seen at multiple places, Johnson pointed out. This makes sharing their genetic information somewhat challenging.</p><p>“How do we educate patients? They may be the best people to share it with doctors in other systems. Do we create a little wallet card that they carry?” she asked.</p><p>Some of the grant money also will be used to expand services and physician training to First Orlando Health and Florida State University, and from there to community hospitals across the state, Johnson said.</p><p>“One of the things we will be doing with the grant is showing the state of Florida that we can make a large impact. In the end, it should be most beneficial to patients,” Nelson said, adding that genetic testing will also “improve efficiency and cost effectiveness.”</p><p><i>Contact Kristine Crane at 338-3119 or kristine.crane@gvillesun.com.</i></p>